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Updated: Dec 30, 2025

Nanomechanics of Drug-target Interactions and Antibacterial Resistance Detection
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Vancomycin Heteroresistance in vanM-type Enterococcus faecium.

Ying Zhou1,2, Yang Yang1,2, Li Ding1,2

  • 1Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, China.

Microbial Drug Resistance (Larchmont, N.Y.)
|January 18, 2020
PubMed
Summary

Vancomycin heteroresistance in Enterococcus faecium is poorly understood. This study reveals gene amplification and increased copy number of the vanM gene contribute to high-level resistance.

Keywords:
Enterococcus faeciumcopy numberheteroresistancevanMvancomycin

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Area of Science:

  • Microbiology
  • Molecular Biology
  • Antimicrobial Resistance

Background:

  • Vancomycin heteroresistance in enterococci is difficult to detect with standard methods.
  • The molecular mechanisms driving vancomycin heteroresistance remain unclear.

Purpose of the Study:

  • To investigate the molecular basis of vancomycin heteroresistance in a clinical vanM-type Enterococcus faecium strain.
  • To characterize the genetic alterations leading to increased vancomycin resistance.

Main Methods:

  • Utilized broth microdilution and Etest for susceptibility testing.
  • Performed sequence analysis and Southern blot to examine vanM gene location and copy number.
  • Quantified vanM gene expression levels in resistant variants.

Main Results:

  • Identified vancomycin-resistant subcolonies in a susceptible Enterococcus faecium isolate.
  • Found the vanM gene present extrachromosomally in the parent strain and variants.
  • Observed increased size of vanM-bearing extrachromosomal DNA and elevated vanM copy number and expression in resistant variants.

Conclusions:

  • Partial or complete amplification/transfer of the vanM gene cluster contributes to increased vanM copy number and expression.
  • These genetic changes drive the emergence of high-level vancomycin resistance from heteroresistant Enterococcus faecium.
  • The findings elucidate a mechanism for the development of vancomycin resistance in enterococci.